Town of Freedom Recreation registration
Program Dates: July 8-August 2
Parent 1 name and phone number *
Your answer
Parent 2 name and phone number *
Your answer
Address *
Your answer
Are you or a grandparent a Freedom Town Resident? *
Email *
Your answer
Students 1 Name *
Your answer
student 1 DOB *
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/
DD
/
YYYY
student 1 grade? *
Your answer
Students 2 Name
Your answer
student 2 DOB
MM
/
DD
/
YYYY
student 2 grade?
Your answer
Student 3 Name
Your answer
student 3 DOB
MM
/
DD
/
YYYY
student 3 grade?
Your answer
What days will you attend? *
Required
Medical Needs *
Your answer
Field Trip to Letchworth Nature Center July 12 *
Field Trip to Warsaw Movie Theatre July 19 *
Field Trip to Buffalo Naval Park July 26 *
Does your child need a lunch on swim days and field trips? *
Does your child need a Town of Freedom shirt for field trips? *
What size shirt
Emergency Contact: Name and phone *
Your answer
I do/do not authorize my children listed above to sign themselves out of Freedom Recreation. I understand that this does not give my child the liberty to come and go throughout the day. Once they are signed in, they MUST remain with the group until they sign themselves out for the day. I understand that once they have signed themselves out they are no longer the responsibility of Town of Freedom Recreation Staff. *
The Town of Freedom Recreation Staff have permission to post and share photos of my children on the Freedom Recreation FB Page. *
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